Adult patients with congenital heart disease are at increased risk of a complicated disease course with coronavirus disease 2019 (COVID-19). In a study conducted in 25 European centres, the EPOCH investigators identified 105 adults with congenital heart disease who had been diagnosed with COVID-19. Of these patients, 13 had a complicated disease course, defined as hospitalization requiring non-invasive or invasive ventilation and/or inotropic support or death. Risk factors for a complicated disease course included age (OR 1.3), multiple comorbidities (OR 7.1), obesity (OR 7.2) and cyanotic heart disease (OR 13.2), including unrepaired cyanotic defects or severe pulmonary hypertension with Eisenmenger syndrome.